Provider Demographics
NPI:1447337159
Name:ZIMBARDO CHIROPRACTIC OFFICE, PC
Entity type:Organization
Organization Name:ZIMBARDO CHIROPRACTIC OFFICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZIMBARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP, DIACN
Authorized Official - Phone:914-337-3737
Mailing Address - Street 1:274 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-4419
Mailing Address - Country:US
Mailing Address - Phone:914-337-3737
Mailing Address - Fax:914-771-6049
Practice Address - Street 1:274 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-4419
Practice Address - Country:US
Practice Address - Phone:914-337-3737
Practice Address - Fax:914-771-6049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006140111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXBWLMOtherBCBS
NYXBWLMOtherBCBS